Early Revision for Multiple Folds (Severe Case: Resolving Multiple Folds and Hollowed Lids After Two Failed Early Revisions Elsewhere)
Photo at first consultation. She had her original eyelid surgery at a clinic outside Seoul, then underwent two consecutive early revisions at another clinic in Seoul. Each round produced new problems, leaving her with hollowed lids and multiple folds when she came to us.
Early revision cannot adjust the crease line itself. What it can address is multiple folds, asymmetric iris exposure, over-correction of ptosis, or difficulty opening the eye.
Q) Why can't the crease line be corrected during early revision?
Because we have to work through the existing incision line. Cutting a new line so soon after the previous surgery would isolate the strip of skin between the two incisions from its blood supply, leading to tissue necrosis.
Q) When can the crease line be corrected?
Six months out, at the earliest.
Pre-op view.
Post-op: the crease folds cleanly and the hollow has been resolved.
Q) Does the hollowed area on the lid require fat grafting?
Sometimes, but more often it isn't necessary. This patient did not have fat grafting.
We're glad the result came out well. The patient mentioned she had originally wanted a low crease, but her first clinic had excised a significant amount of skin.
We will evaluate at the six-month mark whether further surgery is warranted.
With significantly limited skin and three rounds of early revision, some scar-tissue ridging can rise around the incision. This may cause the line to look bent, or produce small temporary multiple-fold-like wrinkles at the medial or lateral end.